Apheresis Procedure

Therapeutic Apheresis

Therapeutic apheresis is a medical procedure that selectively removes harmful blood components or disease-causing substances by passing blood outside the body through a specially designed filter system. Apheresis therapy is known for its good tolerability, outpatient feasibility, and impressive clinical results across numerous indications. Importantly, the immune system remains unaffected, and the purified plasma or blood is returned to the body. 

For apheresis, patients have two accesses placed in the veins of their arms. Blood is then directed through a tubing system into the apheresis device and, after purification, returned to the body via the filter system. Apheresis treatments are performed on an outpatient basis in specialized centers, as close collaboration between the physician, staff, and patient is essential. The procedure typically does not lead to significant losses of electrolytes or antibodies and is therefore generally well tolerated.

Apheresis Device and Filter

In our practice, we utilize the AferSmart filter system from Medica, a unique multi-therapeutic platform enabling the combination of various apheresis techniques. This innovative system integrates the effectiveness of four methods into one treatment. 

The AferSmart filter system uniquely combines the following apheresis techniques:

  1. Hemoperfusion: This method focuses on the targeted removal of toxins, contributing to overall health improvement. When combined with specific chelators, a more efficient elimination of heavy metals can be achieved. This therapy is frequently used in conjunction with other treatments and can provide relief for conditions such as poisoning, liver disease, or immune disorders.
  2. Lipid Apheresis This is an effective method for the selective removal of LDL cholesterol, lipoprotein(a), and triglycerides from the blood. By employing a specialized filter system, these harmful lipids are selectively eliminated. Lipid apheresis is applied, for example, in patients with severe lipid metabolism disorders where conventional drug therapies are not sufficiently effective.
  3. Immunofiltration This is an efficient method for filtering viruses, antibodies, autoantibodies, inflammatory mediators, bacteria, and other harmful substances from the blood. This therapy is utilized to modulate the immune system and reduce inflammation. Immunofiltration can have a positive impact on various conditions such as autoimmune diseases, infections, or inflammatory processes.
  4. Rheopheresis This is an effective procedure for improving microcirculation by selectively removing highly viscous blood components. Circulation disorders, such as peripheral arterial occlusive disease or certain neurological disorders, can be treated with rheopheresis.

By combining these four techniques, the AferSmart filter system offers our patients a comprehensive and personalized treatment option tailored to their specific needs.

Application of Therapeutic Apheresis

Therapeutic apheresis with Toxopherese® is based on extensive experience and scientific research. This innovative method utilizes thermal filtration and double membrane technology to efficiently enhance filter performance. 

Therapeutic apheresis with Toxopherese® removes burdensome, harmful substances from the blood. Plasma is separated from the blood, thermally heated, and then purified in the filter. Depending on the indication, this procedure allows for various types of extracorporeal substance removal.

The process eliminates the body of certain heavy metals, harmful metabolic products, solvents, and toxic substances. With therapeutic apheresis, pathogenic components and pathological autoimmune antibodies can be selectively filtered from the body, while necessary substances remain in the blood and typically do not require substitution. As a result, capillaries are cleansed, and blood flow properties are improved.

A consequence of this treatment is the increased oxygen and nutrient supply to the cells of all organs, resulting in a significant improvement in cellular metabolism activity. At the same time, there is a marked reduction in inflammatory substances such as CRP (among other pro-inflammatory cytokines), as well as cholesterol and blood lipids. Good circulation, oxygenation, and nutrient supply to cells and organs are fundamental for healing and regeneration.

Apheresis Procedure Diagram

Therapeutic Apheresis is a medical procedure that leads to sustainable improvement of microcirculation. By purifying the blood, harmful substances and pathological proteins are removed, resulting in enhanced blood flow in the terminal vessels of the arteries (arterioles, capillaries). This allows for improved oxygen and nutrient supply to the tissues and enhances the efficiency of the mitochondria, which act as the powerhouses of the cells. 

The OHTTA Combination Therapy by Trapp

The combination of ozone high-dose therapy and therapeutic apheresis.

For several months now, we have been employing two distinct yet highly effective treatment modalities in our practice, each with a broad spectrum of therapeutic effects, synergistically combined into a highly potent treatment regimen known as OHTTA Therapy – the combination of Ozone High Dose Therapy (OHT) and Therapeutic Apheresis (TA), precisely sequenced one after the other. 

This approach not only merges the beneficial therapeutic effects of both modalities (see below), but also mitigates any potential adverse effects, such as the possible induction of an OHT-related Herxheimer-Jarisch reaction (temporary worsening of symptoms during medical treatment when the body reacts to the release of toxins from dying pathogens). This is achieved through the filtration of intensified precipitated toxins, as well as viral, bacterial, and fungal components in the blood plasma immediately following OHT, via the subsequent TA. The elimination of toxins encompasses chemical (environmental toxins like heavy metals, plasticizers, pesticides, fungicides, herbicides, flame retardants, pharmaceuticals/toxins, etc.) and biological toxins such as fungal toxins, as well as bacterial toxins (endo- and exotoxins) in sepsis and metabolic toxins in liver failure.

Especially for patients with chronic diseases with environmental medicine backgrounds, often accompanied by concurrent multi-pathogen infections, this treatment regimen constitutes an unrivaled and potent therapeutic duo.

Initial specialized laboratory analyses of eluate/retinate samples (extracted fluid/eluate) have demonstrated that compared to TA monotherapy, OHTTA Combination Therapy can eliminate a multitude of substances requiring elimination from the blood plasma through filtration. Therefore, OHT is also regarded as a detoxification enhancer for TA, among other benefits. Moreover, visually, the eluate/retinate filtered in combination therapy is significantly darker compared to that from TA monotherapy.

Darker eluate (left) after OHTTA Combination Therapy and lighter eluate (right) after TA.

Ozone High Dose Therapy

Ozone therapy is a medical treatment method wherein medical ozone (O3), a specialized form of oxygen, is introduced into the body in the form of an ozone-oxygen mixture. 

This therapy demonstrably enhances microcirculation and cellular oxygenation, directly leading to an improvement in cellular metabolic activity. It also reduces inflammation, activates and strengthens the immune system, and significantly reduces pathogen load (viruses, bacteria, fungi) due to ozone’s virucidal, bactericidal, and fungicidal properties.

Natural ozone therapy, such as the High Dose Therapy by Univ. Doz. Med. Rat Dr. Lahodny and medical ozone therapy (high dose ozone therapy), utilizes ozone (O3) as a powerful component of the treatment. Ozone is a high-energy, active form of oxygen and a potent oxidizing agent, widely used in water treatment and disinfection.

Ozone High Dose Therapy (OHT) also activates the body’s own stem cells to promote healing and health, as extensively demonstrated by Dr. Lahodny in numerous scientific studies.

In this procedure, approximately 150-200 ml of blood is drawn from the patient’s arm vein in a cycle. The blood is collected in a specially designed vacuum bottle containing a coagulation inhibitor. Alternatively, a dose of an anticoagulant is administered intravenously to the patient prior to blood collection. Subsequently, the blood is enriched with an ozone-oxygen mixture for approximately 1 minute. This process is typically repeated 10 times. The required treatment duration is approximately 60-90 minutes.

OHT not only offers a therapeutic option for existing illnesses but also has preventive effects by addressing asymptomatic or incipient health problems before they manifest. Regular OHT sessions conducted every 6 months serve as an excellent preventive medical investment.

The following conditions are suitable for OHT:

  • Post-vacation syndrome
  • Long Covid syndrome
  • Fatigue or CFS (Chronic Fatigue Syndrome)
  • Burnout
  • Revitalization for weakness and exhaustion
  • Immune system strengthening
  • Acute and chronic bacterial and viral infections, fungal infections
  • Sleep disorders
  • Polyneuropathies
  • Arthrosis, arthritis
  • Vasomotor headaches, migraines
  • Neuralgias, including trigeminal
  • Pain related to spinal conditions
  • Rheumatic diseases
  • Metabolism-related disorders
  • Inflammation
  • Lymphatic flow disorders
  • Inner ear disorders (dizziness, tinnitus, sudden hearing loss)

Therapeutic Apheresis Applications

Therapeutic Apheresis has been a globally used medical procedure for over 25 years. As a double membrane filtration apheresis, it is known for its gentle body-regulating effects and its versatile applications. 

Its areas of application include age-related macular degeneration, chronic and acute immune system disorders, Long Covid, Post-Vac, rheumatic diseases, familial hypercholesterolemia, lipid metabolism disorders, ulcerative colitis, Crohn’s disease, dilated cardiomyopathy, Lyme disease, autoimmune diseases, heavy metal poisoning, multiple sclerosis, myasthenia gravis, Guillain-Barré syndrome, diabetic foot syndrome, and sudden hearing loss.

Apheresis therapy is primarily employed in four major groups of diseases: severe lipid metabolism disorders, autoimmune diseases, microcirculation disorders, and conditions where toxins have accumulated in the body.

Dr. Trapp is the first ophthalmologist worldwide to use Therapeutic Apheresis for the treatment of macular degeneration.

Therapeutic Apheresis can reduce or remove the following substances from your blood plasma:

  • Autoantibodies against nerve structures 
  • Circulating pathogenic immune complexes
  • Increased oxygen pressure in tissues as a necessary prerequisite for initiating regeneration and recovery in complex disease entities
  • Optimization of blood flow properties as a necessary prerequisite for initiating regeneration and arresting progression
  • Elevation of reduced mitochondrial ATP (energy substance of all cells) as a positive and necessary metabolic effect
  • Reduction of nitrosative and oxidative stress in cells measured by the significant reduction of nitrotyrosine and MDA-LDL
  • Abnormal haptens consisting of heavy metals/solvents/pesticides/nanoparticles
  • Abnormal antibodies/paraproteins
  • Rheumatoid antibodies (cCP and rheumatoid factor)
  • Autoantibodies against connective tissue
  • Autoantibodies against vascular structures
  • Autoantibodies against muscle structures
  • Autoantibodies against cardiac structures
  • Reduction of over-regulated interleukins
  • Deregulated interleukins or inflammatory molecules
  • Virus particles (including hepatitis C and HIV)
  • Reduction of systemic vascular inflammation measured by the significant reduction of Lp-PLA2 (Lipoprotein-Phospholipase A2)

The HoloBiom® Concept

Therapeutic Apheresis with Toxopheresis® alone cannot guarantee that a patient will be cured. To improve the patient’s condition towards recovery, it is essential to consider the patient’s entire environment. The human body consists not only of its own cells but also hosts 10 times more foreign cells such as bacteria and viruses that live in a symbiotic relationship. Therefore, they should also be included in diagnosis and therapeutic treatment. Improper nutrition and environmental toxins severely damage our “cohabitants,” and it is crucial to protect and regenerate them to maintain our well-being. For this reason, we use the HoloBiom® Concept in our daily work, which consists of the following elements: 

A holistic view of the patient and their environment
Diagnosis and treatment of not only physical but also psychological and social factors
Consideration of the symbiotic relationship between human cells and foreign cells
Protection and regeneration of “cohabitants” through targeted nutrition and detoxification

In summary, Therapeutic Apheresis with Toxopheresis® is an important part of treating certain diseases. However, it is equally important for sustainable recovery to consider the entire environment of our patients. The HoloBiom® Concept offers a holistic approach to comprehensively treating the patient.

Therapeutic Apheresis and Long COVID

Long-term consequences of COVID-19, also known as Long COVID, can include impairments to physical and mental health as well as limitations in functionality and quality of life. The symptoms vary widely and can occur singly or in combination and for varying durations. There is currently no uniform definition of Long COVID. 

A promising treatment method for Long COVID patients is blood washing procedures. These procedures have been found to be effective in removing triggering clotting factors and inflammatory mediators, autoantibodies, as well as spike proteins typical of Corona infections. In Long COVID patients, apheresis treatments have led to significant improvements in oxygen saturation, decreased neurological symptoms, and demonstrated improvements in lung function.

Among the most common long-term health consequences of COVID-19 reported in patient forums or observed in studies are fatigue, chronic fatigue, and reduced endurance, headaches, breathing difficulties, olfactory and gustatory disturbances, muscle weakness and pain, concentration and memory problems, depressive mood, as well as sleep and anxiety disorders and hair loss. Other symptoms may include chest pain, palpitations, and heart palpitations, kidney and metabolic diseases such as diabetes mellitus, as well as thromboembolism. Myocarditis has also been observed.

If you suffer from Long COVID, apheresis treatment can be a promising option. Initially, two apheresis treatments are performed with a one-week interval. Based on laboratory values and the clinical picture, it is determined when additional apheresis treatments are advantageous. It is also advisable, among other things, to determine the genetic degree of inflammation to recognize whether further apheresis treatments are necessary. Targeted laboratory analyses in patients after Covid infections should be conducted before and after apheresis to document the progress of healing.